1. Field of the Invention
The present invention relates to a hydrodynamically propelled catheter for the placement of temporary pacemaker leads into the right ventricle of a patient.
2. Description of the Prior Art
Modern cardiology would not have been nearly so successful if cardiac catheterization had not been realized, initially, for diagnostic and, subsequently, for therapeutic purposes. Cardiac catheterizations are conducted quite routinely today, with the results of such procedures normally being expressed in emperical measurements, and these measurements are used in both diagnosis and treatment.
A primary field of cardiac catheterization treatment is right ventricle pacing, for the insertion of temporary pacemaker leads into the right ventricle, by using a catheter to insert those leads. According to today's relatively standard catheterization procedures, the cephalic end of the catheter is inserted either through the femoral vein or through the subclavical vein into the patient's right atrium. The relatively delicate portion of the insertion procedure is then to pass the catheter through the tricuspid valve and into the patient's right ventricle. A primary purpose of the investigation and study resulting in the development of the hydrodynamically propelled catheter of this invention was to simplify entry into the right ventricle for the purpose of minimizing the operation time and, thus, reducing additional stress to the already "hemodynamically" damaged patient. As is set forth in greater detail below, it has been determined that the use of a hydrodynamically propelled catheter in accord with this invention efficiently and safely accomplishes those results.
It is, of course, understood that numerous forms of cardiac catheters are well known in the prior art. Furthermore, a search of pertinent prior art literature has revealed the existence of devices constructed to utilize hydrodynamic forces during the catheterization procedure. A construction for one such catheter is disclosed in U.S. Pat. No. 4,403,985 issued to Boretos and titled Jet Controlled Catheter. According to the disclosure of that patent, the leading end of a catheter tube may be controlled, directionally, by pressurized control fluid issued from selected control ports formed through the tube substantially adjacent its forward end. The catheter of this patent includes a pleated section just rearward of the control ports so that the leading end may bend or turn. Another prior art device is disclosed in U.S. Pat. No. 4,475,902 to Schubert, and titled Device for Introducing Medical Instruments into a Body. According to the disclosure of this patent, at least one nozzle, aimed rearwardly with respect to the tip of the device, is provided. Pressurized fluid may escape from this nozzle to exert a force on the device tip to advance it into the body, thereby transporting an instrument coupled to the nozzle tip through the body. Yet another catheter including a plurality of orifices formed just behind its leading end for the discharge of a fluid to impart a thrusting force to the catheter is disclosed in French Pat. No. 74 13271.
However, without in any way questioning the utility of the prior art devices as disclosed and explained in these patents, it is not only significant but somewhat surprising to note the virtual absence of any technical literature discussing or presenting the desirability of utilizing such prior art catheters for the purpose of placing temporary pacemaker leads into a patient's right ventricle. In fact, the current state of the art seems to utilize, primarily, normal blood flow and manual manipulation as observed by x-rays for temporary pacemaker lead insertion. Even though modern medical technology recognizes the necessity of a relatively swift, non-traumatic passage of the catheter through the tricuspid valve, there appears to be no teaching in the prior patent literature of a cather construction which will accomplish these results by the use of hydrodynamic forces. It is therefore clear that a great need in the art remains for a hydrodynamically propelled catheter construction specifically and uniquely designed for temporary pacemaker lead insertion into the right ventricle of a patient.